Transgender Men Who Experienced Pregnancy After Female-to-Male Gender Transitioning

Washington Hospital Center Department of Obstetrics and Gynecology, Washington, DC; the Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, and the University of California, San Francisco Center of Excellence for Transgender Health, San Francisco, California.

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Abstract

OBJECTIVE:To conduct a cross-sectional study of transgender men who had been pregnant and delivered after transitioning from female-to-male gender to help guide practice and further investigation.MATERIALS AND METHODS:We administered a web-based survey from March to December 2013 to inquire about demographics, hormone use, fertility, pregnancy experience, and birth outcomes. Participants were not required to have been on hormone therapy to be eligible. We used a mixed-methods approach to evaluate the quantitative and qualitative data.RESULTS:Forty-one self-described transgender men completed the survey. Before pregnancy, 61% (n=25) had used testosterone. Mean age at conception was 28 years with a standard deviation of 6.8 years. Eighty-eight percent of oocytes (n=36) came from participants' own ovaries. Half of the participants received prenatal care from a physician and 78% delivered in a hospital. Qualitative themes included low levels of health care provider awareness and knowledge about the unique needs of pregnant transgender men as well as a desire for resources to support transgender men through their pregnancy.CONCLUSION:Transgender men are achieving pregnancy after having socially, medically, or both transitioned. Themes from this study can be used to develop transgender-appropriate services and interventions that may improve the health and health care experiences of transgender men.